Ph. Neville et al., Carpentier-Edwards pericardial bioprosthesis in aortic or mitral position:A 12-year experience, ANN THORAC, 66(6), 1998, pp. S143-S147
Citations number
15
Categorie Soggetti
Cardiovascular & Respiratory Systems","Medical Research Diagnosis & Treatment
Background. The first generation of pericardial valves was withdrawn from t
he market for a high rate of premature failure. With an original design, Ca
rpentier-Edwards pericardial valves promised improved results.
Methods. Seven hundred eighty-seven patients who underwent isolated aortic
valve replacement and 182 patients who underwent isolated mitral valve repl
acement between July 1984 and December 1995 with Carpentier-Edwards pericar
dial bioprostheses in our institution were followed up. The patients' mean
age was 68.3 (aortic valve replacement, AVR) and 63.9 (mitral valve replace
ment, MVR) years. All but five AVR patients were followed up for an average
of 4.7 years after operation, with a total follow-up of 3,624 patient-year
s. All patients with MVR were followed up for an average of 5.3 years after
operation, with a total follow-up of 969 patient-years.
Results. After 12 years, actuarial survival rate is 53% for AVR and 54% for
MVR. Freedom from valve-related complications for aortic versus mitral val
ve replacement is, respectively, 68% and 55%, freedom from valve-related de
ath is 84% and 85%, freedom from thromboembolism 87% and 94%, and freedom f
rom endocarditis 97% and 94%. The behavior of the aortic valve is better th
an that of the mitral valve: freedom from reoperation is 92% and 76%, respe
ctively; freedom from valve failure is 94% and 78%. Age is an important fac
tor, especially in the mitral position: freedom from valve failure is 52% i
n patients younger than 60 years and 100% in patients older than 60 years.
Conclusions. With a low rate of valve-related events at 12 years and a low
rate of structural deterioration, this prosthesis is a reliable choice for
AVR and in patients over 60 years for MVR. A more durable mitral bioprosthe
sis is needed for patients younger than 60 years. (C) 1998 by The Society o
f Thoracic Surgeons.